Call it the never-ending debate
Should Nationals shut down Stephen Strasburg? Or just let him continue to pitch?
The first thing you need to know about Stephen Strasburg's Shutdown Day is that it's going to happen.
No matter how loudly you scream, no matter how eloquently you argue, no matter how many compelling counterpoints you present, the Washington Nationals aren't changing their minds. Period. That's a wrap.
So there is going to come a day, sometime in September, when the Nationals pat their ace on the butt, place his golden right arm in bubble wrap, and say, "Thanks for playing." It's as inevitable as the next Kristen Stewart tabloid blockbuster.
Got that? Excellent. All right, now here's the other thing you need to know about Stephen Strasburg's Shutdown Day:
We're never going to know whether this was the right move or the wrong move.
Doesn't matter if the guy goes on to make his next 486 consecutive starts. Doesn't matter if he breaks down in 2013 or 2018 or 2028. We'll never know. Never. Can't possibly know because we don't live in a what-if world.
It would be awesome if real life were scripted by, say, the creators of "Lost," or the screenwriters from "Sliding Doors." Then we would know what might have been if the Nationals were to decide, "Aw, what the heck. Let's let this guy keep pitching."
But in the absence of parallel universes, we're stuck with this universe. So, as Shutdown Day draws ever closer, the Nationals understand they have no choice but to live with whatever happens. And we give them credit. They're prepared to do that. Or that's what they tell us now, at least.
Those are the facts, friends. And the facts aren't changing. But those facts don't stop people all over baseball from asking, as one NL executive did the other day: "Where's the proof? Where's the proof that if they do this, he won't get hurt?"
And the facts won't stop other people from saying, as another exec did: "I don't think I've ever seen a situation like this. And I don't think I understand it."
There are so many voices just like theirs, uttering those same words. So our mission, with the story you're about to read, is not to spread more hysteria. It's to help each other understand what this team's decision is all about -- but also to examine a couple of key arguments for the other side. So ready? Here we go:
Where's the proof?
Let's start with this important message:
This isn't a decision the Nationals made after clicking on a couple of articles on WebMD. This isn't a decision they made just to see how many Twitter comments they could generate.
Nats general manager Mike Rizzo told ESPN he made this call after consulting with one of America's most esteemed orthopedists (and noted Tommy John surgery pioneer), Dr. Lewis Yocum, and other sports-medicine experts. And guess what?
The sports-medicine community couldn't be more delighted to see a team -- any team -- take a courageous stand like this, with a player this prominent, on a team that might be risking its shot to win a World Series in favor of protecting its ace's health.
Let's hear now from three members of that community -- three men who have spent years trying to peer beyond the surface of pitchers and their often-troubled arms:
• "In baseball, this is as groundbreaking as 'Moneyball' was in 2001," said Stan Conte, senior director of medical services for the Dodgers and a man who has been tracking baseball injury data for more than a decade. "They're taking something off the blackboard and putting it into practice, and I don't know if they're right or wrong. Only the future will tell us. But at least this is not another case where somebody is following tire tracks in the snow off the side of the cliff just because that's the way a lot of people did it before. In baseball, we've done that repeatedly. And there are a lot of wrecked cars at the bottom of that cliff."
• We also spoke with Dr. Jeffrey Guy, medical director and team orthopedist at the University of South Carolina, who trained under Dr. James Andrews at the American Sports Medicine Institute and who, like Strasburg, was a pitcher at San Diego State.
One of Guy's missions, dating back to his work with Andrews, has been a proactive effort to promote pitch counts, innings limits and periods of prolonged rest to protect young pitchers as far down the chain as Little League. And he is gratified, he said, to see signs that "that mentality is spreading and now it's finally getting into all levels of the game, even with a pitcher like Strasburg."
As part of Guy's work, he constantly preaches to young pitchers the need to be shut down -- to "let your body recover, let your ligament recover, let your elbow recover." And it's "amazing," he said, how well even injured pitchers bounce back from those rest periods, "and how strong they feel because they rested."
• Finally, we spoke with Dr. Glenn Fleisig, who works with Andrews at the American Sports Medicine Institute and is widely described as America's most prominent expert on biomechanics. He cited a remarkable ASMI study of teenage pitchers that showed that pitchers who "regularly kept pitching after they were fatigued were 36 times -- that's 3,600 percent -- more likely to have surgery than not have surgery."
"I've been doing research here with Dr. Andrews for 25 years," Fleisig said. "I've done studies where we find two times, three times, five times. I've never found any other study with a 36-times factor."
All of these men made it clear that, although they're following this story, they would never tell any team what to do. It's not their team, their pitcher, their patient.
The number of innings Stephen Strasburg has pitched in the past five years.
|2008||138.1 (97 1/3 college, 41 for Team USA)|
|2009||133 (109 college, five Instructional League, 19 Arizona Fall League)|
|2010*||123.1 (68 major leagues, 55 1/3 minor leagues)|
|2011||44 (20 minor leagues, 24 major leagues)|
|* Had Tommy John surgery on Sept. 3, 2010.|
But if we were to judge the Nationals' stance on Strasburg strictly from a sports-medicine perspective, there would be almost no question that shutting down a pitcher with his history, before he pitches past the point of arm "fatigue," is an intelligent approach to protecting their player.
Is there "proof" that pulling the plug on Strasburg's season -- at 160 innings, 170 innings or any other number -- will keep him healthy? Here's the bad news: There's none. No matter how they handle him.
For one thing, Conte's research has shown that an incredible 50 percent of all starting pitchers wind up on the disabled list anyway. Yessir, 50 percent. And the rate for pitchers 25 and under is even higher. So chances are, Stephen Strasburg is likely to land back on the disabled list sometime in the next couple of years whether he pitches 160 innings this year or 260. Remember that, OK?
Second, there isn't nearly enough information about pitchers who fit Strasburg's profile to guide the Nationals or anyone else. There have been studies, such as the one we just cited, that look at teenage pitchers. But there has never been a similar study, anywhere in the sports-medicine sector of the planet, that has looked at professional pitchers in their early 20s who had Tommy John surgery and tracked their future innings and health.
Nevertheless, Rizzo told ESPN's "Outside the Lines" last week that the Nationals looked at "the workload of 23-year-old pitchers in baseball history that have the stuff, and the arm, and the stress per pitch, that a Stephen Strasburg has." And what they learned, he said, was that "there's no pitcher that's gone from 44 innings pitched in one season, after Tommy John surgery, to 200 the next season, without injury down the road."
We did an informal study of our own after hearing this explanation, and found two pitchers who came close to meeting Rizzo's description. One was Josh Johnson, who had Tommy John surgery at 23 and pitched 209 innings at 25. The other was Kerry Wood, who had the surgery at 22 and then averaged 199 2/3 innings per season from ages 24-26. It's safe to say both had enough health issues afterward to match Rizzo's analysis.
Meanwhile, the Nationals also have an example on their own staff, Jordan Zimmermann. Had Tommy John surgery at 23, at almost the same point in the season as Strasburg. Threw 70 2/3 innings the next year (31 in the big leagues). Was shut down after 161 1/3 innings last year. Back on a "normal" track, and having a sensational season, this year.
But does that mean the right thing to do with Strasburg is what worked for Zimmermann? There's no "proof" of that, either.
"They're two unique individuals," said a member of the sports-medicine community who asked not to be identified. "You really need a larger sample size. The problem is, there isn't one. No one I know of has done that study."
So, if some scientist, some doctor, some statistician -- or even some commissioner of baseball -- wants to launch that research after reading this piece, as a tribute to Stephen Strasburg, we'll waive our usual fee. And if not, oh well, it's hard to fault any team for erring on the side of caution when it comes to health. But
That won't stop some people from asking this fascinating question:
Couldn't he just skip a start or two?
We spoke with one longtime pitching coach who didn't want to be quoted because Stephen Strasburg isn't his player. This coach is all for innings limits, all for pitch counts, all for watching all pitchers carefully to keep them all as healthy as possible. But why, he wondered, aren't the Nationals working to control Strasburg's innings now so he'll be available later, when the games matter most?
"I appreciate the fact that they're being mindful of protecting their players," he said. "I just think there are more creative ways they can do this."
We consider this man to be one of the most thoughtful pitching coaches in the game, and one who has a long track record of keeping pitchers relatively healthy. But one technique he has employed for years to accomplish that is one the Nationals have said they won't even consider:
Let the guy skip a start every once in a while!
The White Sox are doing exactly that with Chris Sale, whose schedule has been worked around off days in a way that has enabled him to go a week and a half between starts three times this year. So why, this pitching coach asked, aren't the Nationals taking the same approach with Strasburg?
"I just don't understand," he said, "why someone isn't saying: 'Let's start managing this different. Let's go with a six-man rotation. Every fourth turn through the rotation, let's skip his start so we can buy him those extra starts later in the year.' That makes so much sense to me. I don't understand this [approach] at all."
Or, if skipping an occasional start is Plan B, what about Plan C: Couldn't the Nationals' creative team come up with some kind of minor injury (blister, acne outbreak, irritated eyebrows) that would give Strasburg 15 days or so to back off and recharge beneath the cover of the disabled list? Happens on a regular basis on other teams.
Seems like a fine idea to quite a few baseball people we surveyed. But here's Rizzo's explanation, to "Outside the Lines," for the Nationals' reluctance to go that route:
"Because every injury expert that we have spoken to [says] the effect of shutting a pitcher down and then ramping him back up and having him throw a full go is much more dangerous than having him pitch through the season and shutting him down," Rizzo said.
"You know, there's a lot of different ways you could trick this thing up," he went on, "and a lot of different ways you could try to stretch him out. We want to do what's best for Stephen in the long run. So we're going to let him pitch on a regular routine, get him to an innings limit that he's comfortable throwing and then shut him down, and ramp him back up in spring training to take us to the next level."
Again, it's clear this is an answer -- and a game plan -- that has been carefully thought out. But is it really "dangerous" to give a pitcher a two-week break in the middle of a long season? This is where the baseball community and the sports-medicine community aren't so sure.
"Let's just say," said ESPN baseball analyst (and onetime Rangers pitching coach) Orel Hershiser, "that this kid pulls his hamstring in May and he's out 90 days. You mean to tell me they'd just shut him down for the year, that they wouldn't bring him back? Of course they would. We do it all the time."
And Hershiser isn't the only one who would argue that, for many pitchers, there might be more benefit than danger to a temporary break in midseason.
"We have it here all the time, with Dr. Andrews," Fleisig said. "Some pitcher comes down here. He has a complete look of worry on his face. Dr. Andrews does an exam and an MRI, and he says, 'Nothing's completely torn. so we'll shut you down for a couple of weeks, then do rehab exercises.' And that's totally a good medical plan.
"If a guy is 100 percent, if he feels just as good as he felt at the beginning of the season, then there might be no reason to shut him down," Fleisig said. "But if a guy is getting tired quicker and he's showing more soreness, the long season is starting to [take its toll], he has to ice more, and his elbow or shoulder is starting to hurt a little more, then it's an excellent idea to shut him down for a couple of weeks. That's how your body recovers."
So, would Strasburg be a pitcher who meets that description? Decide for yourself.
He just came off a six-start stretch in which he had a 4.60 ERA and allowed as many home runs (six) as he had given up in his previous 15 starts combined. And an ESPN study last week also showed that he was tied for the major league lead in most "stressful innings" (i.e., innings of 30 pitches or more).
So, is that a sign of wear and tear, or of arm weariness, or just that he's human? We don't know, obviously. And we shouldn't expect the Nationals to tell us. But we do know this: Not all inning totals are created equal.
"Here's the thing I want you to think about," Fleisig said. "The reporters and everyone else can't just have a count on paper and say, 'Here's how many innings this guy should throw.' Nor should a major league team or pitcher say, 'Here's my count.' Basically, the time to shut it down is when the body is giving signals that 'I'm fatigued.'"
But do those signals automatically show up when a guy hits some magic innings number? Isn't it possible those signals might be pointing toward a temporary shutdown in August instead of a permanent shutdown in September? There are enough voices out there expressing doubts that we'll be debating those two questions for a long, long time.
But maybe not as long as we'll be debating this -- perhaps the ultimate -- question:
How can anyone miss October?
Stephen Strasburg has waited all his life for a season like this. The Nationals have waited all their existence for a season like this. And there's barely a Nationals fan on earth who has witnessed a season like this, not in their town anyhow.
So now here this team is, on the verge of playing postseason baseball games in D.C. for the first time since 1933 -- and the Washington Nationals are about to hit the gong on their best pitcher?
Gulp. They really are. Aren't they?
We ask you this: Has anything like this ever happened? In any sport? Has there ever been a team, potentially headed for a championship, that decided, voluntarily, to stop playing one of its most important players even though he wasn't "hurt"?
If there has, we can't remember it. And other pitchers can't even comprehend it.
• "When you're working out in November and December, that's your ultimate goal, to play in the postseason," said the Phillies' Cole Hamels, whose journey to a World Series MVP award in October 2008 forced him to pitch 79 more innings than he had ever pitched in any season in his life. "And if you get that pulled out from under you, what are you playing the game for?"
• "If you miss out on [the postseason], then you have to realize it's possibly a once-in-a-lifetime opportunity," another World Series MVP, the Cardinals' Chris Carpenter, told the St. Louis Post Dispatch's Derrick Goold. "I've been lucky enough to do it twice, after not being able to do it the one time [because of a nerve injury in 2004] and understanding that might be my only chance. You don't know what's going to happen the next year or the years ahead. And what if this is your opportunity? There's no way you can miss that."
• "I had to have reconstructive surgery because I pitched 260 innings in 1988," said Hershiser. "But I've always said, 'Would I give back the 55 scoreless [innings] and winning the World Series so I could have a longer career?' No way."
The essence of this portion of the story is this: This is why players play. This is why pitchers pitch. They get into baseball to pitch in games that matter, for teams just like this one. So, on some level, wouldn't the importance of these games and this kind of season outweigh the importance of any preconceived plan to protect any pitcher?
This team is built for the long haul. And by shutting down Stephen Strasburg, and Jordan Zimmermann last year, we've proven that we care for our pitchers, we care for the long haul, and we're going to do what's best for their careers and their future because what's best for their careers and their future is best for the Washington Nationals' future.” -- Nationals general manager Mike Rizzo
Chris Carpenter hasn't thrown a pitch since Game 7 of the World Series. Does anyone think he would trade his World Series ring to make 30 starts this season? No chance.
He knew this past October that he was pushing himself beyond his threshold of fatigue and soreness. But that, he said, is "what you're supposed to do. It's not a phenomenon. It's what you're supposed to do. That's what makes you a pitcher. That's what makes you a professional. You pitch. That's what makes you an ace."
Even Hamels, whose team got bounced from the playoffs because of an October Carpenter masterpiece, understands exactly why Carpenter made the sacrifices he made.
"That World Series will go on forever," Hamels said. "He'll always be known for what he did then, not for the season he missed the following year. I don't think anybody will remember Carpenter missing the season. They'll remember how dominant he was in the World Series."
Be aware of this: These October warriors understand the risks they're taking, the potential jeopardy to their futures, when they reach for greatness in the autumn chill. But they go out there anyway.
"It's in the heart and personality of a champion and a big leaguer," said Hershiser. "They've got risk in their heart. They just look at risk and say, 'I'm going for it.' You know, heroes fear taking risk like everyone else. They just spit in its face."
So now imagine being Stephen Strasburg this October, watching those games he has spent a lifetime dreaming about pitching. And it's fair to ask whether the Nationals owe it to him to find some new course that would allow him to pitch those games -- and whether they owe it to his teammates to give all of them the best chance to win a World Series.
Ask any player who missed out on the opportunity to play those games. Ask about the void that leaves. Ask Ben Sheets, who spent eight seasons as a Brewer, waiting for his chance to reach October -- only to have a September elbow issue keep him out of the 2008 postseason. He had to watch Yovani Gallardo, who'd been out since April, take his start. And, four years later, Sheets says:
"I'd have switched spots with Gallardo -- gladly. I had 31 starts that year, but he got to pitch in the postseason and I didn't. And that hurt."
Sheets doesn't want to get mixed up in the Strasburg brouhaha. He said, "It's the Nationals' choice, it's the Nationals' team, it's the Nationals' pitcher, and it's his career." But he understands the potentially powerful ripple effects on any team of losing its best pitcher that close to October, even though this time it isn't because of an injury. It's because a team has made a decision on how best to prevent an injury.
"The biggest thing for me," Sheets said, "is that whatever they decide as a team has got to be the decision. Right or wrong, it's got to be the right decision, meaning if you let him pitch, that's got to be the right thing, 100 percent in [everybody's] mind. You can't change your mind as an organization. And if they don't, be fine with that decision. Don't say, 'If we don't win the World Series, we should have let him.' If you don't win the World Series, and he wasn't there, that's OK. That's the plan. And everybody has to get behind it."
And maybe they all will. But that won't mean this won't be an excruciatingly tough sell for Rizzo once Shutdown Day arrives. Asked last week how he would explain his stance to people in Washington who hadn't seen a postseason game in almost 80 years, the Nationals' GM put it this way:
"I'm going to say to them that we're going to be good for a long, long time," Rizzo said. "And Stephen Strasburg is going to be a prime reason why we're going to be good for a long, long time. This team wasn't constructed to have a short glimpse of prosperity and fade away. This team is built for the long haul. And by shutting down Stephen Strasburg, and Jordan Zimmermann last year, we've proven that we care for our pitchers, we care for the long haul, and we're going to do what's best for their careers and their future because what's best for their careers and their future is best for the Washington Nationals' future."
That's true, of course. And, in another circumstance, in another season, in a parallel universe, maybe no one would argue. But not in this circumstance. Not in this season. Not in this universe.
Shutdown Day is approaching. And soon, Shutdown Day will arrive. And when it does, you know what the Washington Nationals are going to learn?
That it's going to be a lot easier to shut down their best pitcher than it is to shut down this debate -- for the rest of Stephen Strasburg's life.
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